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Message from the chair

Laurie C. Gregg, MD

As District IX immediate past chair, Jeanne A. Conry, MD, PhD, starts her tenure as the 64th president of ACOG, it is an appropriate time to write about leadership. Dr. Conry will lead our national organization with the mantra “Every Woman, Every Time.” It relates to her initiative to enhance well-woman care with recognition of the importance of interconception and preconception care.

ACOG has taken a more in-depth look at leadership in the recent year. At the 2013 Annual Clinical Meeting, Sandra A. Carson, MD, ACOG vice president of education, and Barbara S. Levy, MD, ACOG vice president of health policy, advocacy division, gave an inspiring presentation on leadership paths. ACOG Immediate Past President James T. Breeden, MD, created a leadership task force designed to look at barriers to leadership advancement and successful leadership development tools. The Congress Advisory Council was given a preview of the task force’s discoveries at its meeting at the ACM.

One of the most successful programs for leadership development is the ACOG Robert C. Cefalo National Leadership Institute. Approximately 40 ACOG Fellows and Junior Fellows participate in this intensive four-day course each year in North Carolina. The program is designed to arm physicians with tools to lead transformation in the 21st century for women’s health care. It does such an excellent job of educating members on the skills needed to lead in today’s world that many ACOG districts have held the course locally for members.

With all this attention on leadership, I’ve found that certain pearls of wisdom are repeated often:

It is important for physicians to be leaders in medicine. We all lead our patients’ care, and we should broaden that leadership to the health care system. As Dr. Carson said in her presentation at the ACM, “Physicians must lead American medicine into the future. We can’t shrug this off. We must develop the skills necessary for leadership, stop putting our heads in the sand, and take back health care.”

A leadership path is rarely a straight ladder that is climbed steadily. There are rest stops and chutes. Although businesswoman SherylSandberg would tell us to “lean in” at every opportunity, sometimes life circumstances dictate that we balance that lean. According to Dr. Levy, “Sometimes people have trouble recognizing that the path toward one’s goals is not a steady, upward incline. It’s not an escalator, it’s a jungle gym.” I encourage you to be mindful to embrace and enjoy your time on the playground.

Many times, progression on the path to leadership is guided by good fortune and timing. Opportunities appear at unanticipated times and are grasped depending on life circumstances.

Dr. Conry may well have been born with genes for potential leadership; nonetheless, she had the good fortune of skilled mentors who actively supported her and her leadership development. She is the mentor now. Dr. Conry provides us with a role model for leadership in medicine and acknowledges that she’s spent time on her own “jungle gym.” She has taken advantage of her opportunities, and we look forward to the fruits of her presidential year.

Special preview: 2013 ADM in Maui

John P. McHugh, MD, District IX newsletter editor and Section 7 chair

District IX members are getting excited about the upcoming Annual District Meeting in Maui, HI, September 26–28, with Districts V, VI, and VIII. District VIII is the meeting’s host district, and I had the pleasure of speaking with Susan M. Lemagie, MD, District VIII chair, about what this meeting will have to offer.

Dr. Lemagie, what can you tell our members about the upcoming ADM? John, it is going to be a fantastic meeting. Let’s start with the group. Districts V, VI, VIII, and IX are participating, which means attendees will be coming from 26 states and territories in the US, seven provinces and territories in Canada, and all of Central America. The meeting should have a good turnout with a great mix of people.

Yes, it will be a great chance to see colleagues. Can we talk about Maui for a minute?The meeting is being held at the Grand Wailea Resort, which is a Waldorf Astoria hotel. It’s one of the great hotels on the island at an unbelievable rate. The grounds are amazing, featuring gorgeous beaches and world-famous pools. Who wouldn’t want to stroll outside after a session right onto the sand and jump into the beautiful waters of the Pacific? There are also plenty of activities for families and members who enjoy dining, nightlife, and culture.

OK, we got that out of the way. Now, what will we learn at the meeting?There are so many great topics! Amy B. Tuteur, MD, a practicing ob-gyn in Boston, will be addressing everything ob-gyns need to know about home birth. Doctors should educate themselves about what is going on in their communities. Rosanne M. Kho, MD, a robotic surgeon at the Mayo Clinic in Phoenix, will speak about the benefits of robotic and vaginal hysterectomy.

The meeting will feature a series of talks called “Maintenance of Confidence” that will update attendees on important issues within the ob-gyn specialty. We will also have a number of lectures on controversies in ob-gyn. The final topics of these lectures will be selected based on suggestions from members.

What is all this talk about oral boards? In Maui?The rumors are true. We are hosting mock oral boards. Yes, in Maui. The boards are open to Junior Fellows who would like to practice and mentors who would like to be mock examiners. It will be a great opportunity for all involved. Ralph W. Hale, MD, past ACOG executive vice president, is also hosting a session on leadership training for Junior Fellows and young physicians.

OK, let’s talk about fun. Are there any social activities scheduled?We have another Dancing with the Docs competition planned for this meeting. Last year, the District VIII Junior Fellows showed some great skills on the dance floor and won the competition. This year, I'm hearing they may have serious competition! If you want to take in some of the natural beauty of Maui, an astronomy talk will be held at the Haleakala Observatory.

Should we register now?Absolutely! The room block is limited, and about half the rooms are already gone. Oh, and by the way, the rate is available three days before and after the meeting dates. Online registration is available now!

The Third Annual California Breastfeeding Summit convened in Garden Grove, CA, January 31–February 1, with the theme of “Strengthening Breastfeeding Support throughout the Continuum of Care.” Physicians and other professionals across California joined Ron Chapman, MD, MPH, director of the California Department of Public Health; LaurenceGrummer-Strawn, PhD, MPA, MA, chief of the nutrition branch at the Centers for Disease Control and Prevention (CDC); and other public health leaders to learn about evidence-based maternity practices that support breastfeeding. It was also an opportunity to foster partnerships between hospitals, physicians, and Women, Infants, and Children (WIC) agencies so that mothers are supported at every level of care.

California is leading a national movement to support the 90% of women who choose to breastfeed in its state. One-third of Baby-Friendly hospitals are in California. In addition, WIC is providing new levels of support to the 60% of babies born in California who are WIC eligible by establishing regional breastfeeding liaisons. Please contact your local WIC office for further details about how it can assist patients after hospital discharge.

Of particular interest to ob-gyns was a talk from Raylene Phillips, MD, MA, a neonatologist at the Loma Linda Children’s Hospital in Palo Alto, CA, about how critical the first hour after birth is in starting the breastfeeding relationship. Allowing babies to remain continuously skin-to-skin during this hour gives them the chance to instinctively find their way to the breast. Dr. Phillips also described how maternity practices, such as delaying the infant bath by 12 hours, increases breastfeeding by 40% and decreases hypoglycemia in the newborn. The Healthy Children Projectwebsite offers more information for patients and staff on this topic.

Dr. Grummer-Strawn concluded the summit with a lecture describing the CDC’s commitment to breastfeeding. Once thought of as a private, personal issue, breastfeeding is now considered a public health priority. The CDC is shifting its focus from breastfeeding promotion to breastfeeding support. Dr. Grummer-Strawn reinforced the importance of implementing national and state policies that provide support to women who choose to breastfeed but are unable to do so for as long as they want.

Proposed changes to MICRA increase health care costs, harm patients

Shannon Smith-Crowley, JD, MHA, District IX director of government relations

On May 2, a coalition of consumer groups and trial lawyers announced plans to overturn the Medical Injury Compensation Reform Act (MICRA) through a ballot initiative if no legislative action is taken to increase the act’s noneconomic damages cap.

Trial lawyers want to quadruple the noneconomic damages cap, which would significantly increase health care costs for patients and operating costs for providers, hospitals, and community clinics that are already struggling to keep their doors open. At a time when California is working hard to implement federal health care reform and provide increased access to health care for all Californians, changes to MICRA would be the worst possible overreach at the worst possible time.

The coalition has until September to submit a proposed initiative to qualify for the November 2014 general election ballot. There is no language for a bill or ballot initiative at this point.